While similar in many ways, palliative and hospice care are different.
Palliative care treats symptoms and the side effects of disease and treatment. It can also address emotional, social, practical, and spiritual problems that result from illness. In short, palliative care helps people with serious illnesses to feel better and to enjoy an improved quality of life.
Serious illness affects more than just the physical body. It can touch all areas of a person’s life and the lives of family members.
Palliative care may begin when an illness is diagnosed, throughout treatment, during follow-up, and/or at the end of life. It is important to note that during palliative care, medical care may be administered by the patient’s regular physicians to help cure or treat the disease.
There are providers who specialize in palliative care, but any health care provider can give palliative care. It can be administered in a hospital or cancer center, at home, or in a nursing home. Palliative care can be given by doctors; nurses and nurse practitioners; physician assistants; registered dietitians; social workers; psychologists; physical, occupational, and massage therapists; and spiritual advisors.
Palliative care can address:
- Physical problems, such as pain, trouble sleeping, shortness of breath, loss of appetite;
- Emotional, social and coping issues, such as stress, anxiety, hopelessness, or depression;
- Practical problems, such as financial or job-related issues, insurance, and legal concerns; and
- Spiritual matters that question faith.
Both palliative care and hospice care provide comfort. While palliative care can begin at diagnosis and during treatment of the disease, hospice care begins after treatment of the disease is stopped, when it is determined the patient will not survive the illness.
Hospice care includes palliative care and addresses the patient’s physical, emotional, and spiritual needs as well. Hospice assists with daily activities – administering medications, bathing, and dressing. It does not provide full-time caregivers and requires that a caregiver (family member or hospice visiting nurse) be present during this time. No curative medical treatment is given during hospice care. A patient must generally be terminal or within six months of end-of-life to be eligible for most hospice programs. The goal is to administer compassionate, comfort care during this period.
Hospice care is a philosophy that always includes palliative care and attends to the pain and comfort issues of terminally ill patients until their deaths.
Patients receive relief from pain, shortness of breath, and other symptoms so they can focus on the people and things they care about the most. Hospice doesn’t mean “giving up.” It means the emphasis is on the quality of life instead of trying to cure a disease. Hospice is for family members, too. It offers counseling and help from volunteers, so family members have a break to attend to practical matters.
One thing to keep in mind is that hospice isn’t always a permanent choice. If, for example, a patient’s kidneys are failing, and hospice is chosen rather than continuing with dialysis, the patient can change his or her mind, stop hospice care, and start back on treatments.
More than 90 percent of hospice care is paid by Medicare’s hospice benefit and care can be administered anywhere the patient calls home.
Both palliative and hospice care are an interdisciplinary approach to specialized medical and nursing needs of people with life-limiting illnesses. They focus on providing compassionate care and relief from the symptoms, pain, and physical and mental stress of a serious illness.
If you have questions about palliative or hospice care, a good place to begin is to talk with your family member’s physician.
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